April 30, 2025
With the understanding that on September 30, 2025, the federal statute that authorizes the continuation of the (federal) CCBHC Demonstration Program is set to expire, the NYS Council has been pushing state leaders including DoH and the Governor’s Office to quickly file a State Plan Amendment (SPA) with CMS that requests approval for the state to bring all CCBHC Demo Services into New York State’s Medicaid Plan. The first step the state needed to take was to publish a Notice in the NYS Register informing the public of its intent to do so (SEE BELOW). Recently we ramped up our advocacy to get the ball rolling and apparently it worked! Below you will find the Notice that appeared in today’s New York State Register. (Hallelujah!)
Tomorrow morning during our Thursday morning Member Support call I will discuss the advocacy required to ensure the NYS CCBHC Demo Program remains entirely intact and with no disruption in continuity of care. But for the moment this is a victory.
See you tomorrow morning at 9:15!
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(April 30 NYS Register)
The Department of Health proposes to amend the Title XIX (Medicaid) State Plan for non-institutional services consistent with the end of New York State’s Certified Community Behavioral Health Clinic (CCBHC) demonstration on September 30, 2025. The following changes are proposed:
Non-Institutional Services
Effective on or after October 1, 2025, existing providers participating in the CCBHC demonstration will continue delivering and being reimbursed for comprehensive behavioral health services beyond the Federal demonstration period. CCBHCs provide a comprehensive range of ambulatory mental health or addiction disorder, including substance use disorder, gambling disorder, and problem gambling services to individuals throughout New York State, including:
• Crisis mental health services including 24-hour mobile crisis teams, emergency crisis intervention and crisis stabilization,
• Outpatient mental health and addiction services, including gambling disorder, problem gambling, and substance use disorder with ancillary withdrawal services,
• Screening, assessment, and diagnosis including risk management,
• Physical health screening and monitoring,
• Case management,
• Psychiatric rehabilitation services,
• Peer support, counseling services, and family support services, and
• Services for members of the armed services and veterans.
This amendment will allow New York State to maintain the CCBHC program model by ensuring all services in the program model are covered benefits in the State Plan, and that the reimbursement methodology that allows the CCBHC provider to utilize a Prospective Payment System (PPS), which is a provider-specific cost-based service rate developed in accordance with Federal standards contained in the Protecting Access to Medicare Act of 2014 (H.R. 4302) for reimbursement for a range of identified state plan services, will also continue.
There is no additional estimated annual change to gross Medicaid expenditures as a result of converting the CCBHC program model from the federal demonstration to the Medicaid State Plan.
Effective on or after October 1, 2025, this amendment will revise the Quality Bonus Payment (QBP) methodology consistent with federal guidance issued in February 2024, expanding the reporting of quality measurement indicators, and establishing performance measure thresholds and payments under the program.
The estimated net aggregate increase in gross Medicaid expenditures attributable to the QBP in the budget, beginning in state fiscal year 2027, is estimated to be $15.3 million.
The public is invited to review and comment on this proposed State Plan Amendment, a copy of which will be available for public review on the department’s website at: http://www.health.ny.gov/regulations/state_plans/status.
Individuals without Internet access may view the State Plan Amendments at any local (county) social services district.For the New York City district, copies will be available at the following places:
New York County 250 Church Street New York, New York 10018
Queens County, Queens Center 3220 Northern Boulevard Long Island City, New York 11101
Kings County, Fulton Center 114 Willoughby Street Brooklyn, New York 11201
Bronx County, Tremont Center 1916 Monterey Avenue Bronx, New York 10457
Richmond County, Richmond Center 95 Central Avenue, St. George Staten Island, New York 10301
For further information and to review and comment, please contact: Department of Health, Division of Finance and Rate Setting, 99 Washington Ave., One Commerce Plaza, Suite 1432, Albany, NY 12210, spa-inquiries@health.ny.gov